双侧斜位X线片判定颈椎椎弓根螺钉置入孔道准确性的实验研究

Verification of the accuracy of pedicle screw pilot hole placement in cervical spine combined with bilateral oblique X-ray films with the spiral guid wires

中文关键词:  颈椎椎弓根 导针 X线片

英文关键词:Cervical pedicle,Guide pin,X-ray film

中文摘要:

  目的:探讨螺旋形导针配合双侧斜位X线片判断颈椎椎弓根螺钉置入孔道准确性的可行性。方法:在干燥人C3￣C7标本的椎弓根峡部环扎钢丝,拍摄X线片。做出通过椎弓根中央及破坏椎弓根内、外侧壁种孔3道,插入螺旋形导针,拍摄X线片。分别采用前后位与单侧斜位X线片相结合、单侧斜位X线片及双侧斜位X线片判定导针置入位置,比较X线片判定结果与实际所做孔道的符合率。结果:斜位X线片上,椎弓根椭圆形影是由椎弓根峡部形成的,螺旋形导针在判断椎弓根置入孔道位置时,双侧斜位X线片法的敏感性、特异性和准确性高于前后位与单侧斜位片结合法和单侧斜位片法。前后位与单侧斜位X线片相结合、单侧斜位X线片、双侧斜位X线片三种读片方法判定导针置入位置准确性分别为75.78%、88.89%、93.05%,三者之间存在显著性差异(P<0.05)。判断位于椎弓根中央、穿破内侧椎弓根皮质和穿破外侧皮质这3种孔道位置时,双侧斜位X线片法的准确性分别为90.21%、90.76%、94.74%,高于其它两种读片方法(P<0.05)。结论:螺旋形导针配合双侧斜位X线片用于判断颈椎椎弓根螺钉置入孔道位置的准确性是可行的。

英文摘要:

  Objective:To evaluate the accuracy of cervical pedicle screw pilot holes placement by bilateral oblique X-ray films with the spiral wires as the guide pin.Method:Wire markers were placed on the waist of the pedicle(C3~C7),and then radiographs were taken.T